Methods:
Retrospective review of 20 eyes of 20 patients with uncomplicated, macula-involving rhegmatogenous retinal detachments who underwent successful retinal detachment repair with pars plana vitrectomy or combined pars plana vitrectomy and scleral buckle. All patients underwent clinical examination, SD-OCT, and FAF of the macula preoperatively and post-operatively for up to two years. Patients who were found to have persistent SMF on SD-OCT after surgery were identified and their imaging characteristics, duration of fluid and associations with visual outcome were further analyzed.

Results:
Six out of twenty eyes were identified with persistent SMF on SD-OCT following surgery. Other SD-OCT features identified post-operatively were photoreceptor outer segment irregularity, inner segment/ outer segment disruption, external limiting membrane discontinuity and outer nuclear layer changes. The SMF gradually resolved in all cases between 6 months to 2 years and was associated with a delayed improvement in visual acuity and slow improvement in the other associated SD-OCT abnormalities. Four patients showed a patchy hypoautofluorescence pattern, which correlated to pockets of SMF and ultrastructural abnormalities on SD-OCT early in the post-operative course. These areas ultimately became hyperautofluorescent in the late follow-up period. Two patients showed a curvilinear hyperautofluorescence pattern early in the post-operative course.

Conclusions:
Persistent SMF after successful retinal detachment surgery may persist for months to years and can cause delayed visual recovery. FAF changes may correspond with areas of persistent SMF and ultrastructural changes in the SD-OCT, which suggests a potential role of RPE dysfunction in this disease process.